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MEMOIR 



JONATHAN LETTERMAN. M.D. 

SURGEON UNITED STATES ARMY AND MEDICAL DIRECTOR OF THE ARMV OF THE POTOMAC 



BREVET LIEUT. -COLONEL BENNETT A. CLEMENTS 

SURGEON UNITED STATES ARMY 



Reprinted from the Journal of the Military Service Institution, Vol. iv, 
No. 15, September, 1883. 



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MEMOIR 

OF 

JONATHAN LETTERMAN, M.D., 

Surgeon United States Army and Medical Director of the Army of the Potomac 

By BREVET LIEUT.-COLONEL BENNETT A. CLEMENTS, 
Surgeon United States Army. 

" the iniquity of oblivion blindly scattereth her poppy, and deals with the 

memory of men without distinction to merit of perpetuity. * * * * 

" Who knows whether the best of men be known, or whether there be not more 
remarkable men forgot, than any that stand re?nembered in the known account of 
time." — Sir Thomas Browne, 1686. 

It is the purpose of this memoir to perpetuate the name and 
to honor the memory of an officer who effected an organization 
of the Medical Department of an army in the field, that not only 
contributed in a large degree to the discipline and efficiency of 
the foremost Army of the Republic, but also robbed war of 
many of its horrors ; who left behind him for the use of those 
to come the record of the means by which these noble ends may 
be again achieved ; and who, in rendering this great service to 
his country, added a brilliant page to the record of the humane 
character of his profession. ' 

Dr. Jonathan Letterman was born in Canonsburg, Washington 
County, Pennsylvania, on December 11, 1824. His father was 
an eminent surgeon and practitioner of medicine in the western 
part of that State, and carefully educated his son for his own 
profession. His studies were directed by a private tutor until 
he entered Jefferson College in his native county in 1842, and he 
graduated thence in 1845. 

Pursuing his medical studies, he graduated at the Jefferson 

1 The writer is indebted to General C. H. Crane, Surgeon-General United States Army, and to 
Dr. Charles O'Leary, President of the State Medical Society of Rhode Island, for valuable aid in 
the preparation of this paper. 

Reprinted from the Journal of the Military Service Institution, Vol. iv, 
No. 15, 1883. 



2 MEMOIR OF LETTERMAN. 

Medical College, Philadelphia, in March, 1849. ^ n the same 
year he passed a successful examination by the Army Medical 
Board in New York City, and was appointed an assistant sur- 
geon in the Army, June 29, 1849. 

He served in Florida in the campaigns against the Seminole 
Indians from his appointment until March, 1853 ! ^ e was then 
transferred to Fort Ripley, Minnesota, and in May, 1854, 
marched with troops from Fort Leavenworth, Kansas, to New 
Mexico. In that department he served at Fort Defiance in the 
country of the Navajo Indians, and was engaged in Colonel 
Loring's expedition against the Gila Apaches. 

He continued on duty in New Mexico until the autumn of 
1858, when he was granted a leave of absence after his service of 
four years on the frontier. In 1859 ne was on duty at Fort 
Monroe, Virginia, and in the office of the late General Satterlee, 
United States Army, who then was the Chief Medical Purveyor 
for the Army, i860 found him in California, where he was 
engaged in Major Carleton's expedition against the Pah Ute 
Indians. 

In November, 1861, he accompanied troops from California 
to New York City, and was soon after on duty with the Army 
of the Potomac. In May, 1862, he was made Medical Director 
of the Department of West Virginia. He served in this position 
but a short time, for on June 19th of this year he was assigned 
to duty as Medical Director of the Army of the Potomac, suc- 
ceeding Surgeon Charles Tripler, United States Army, who had 
been nominated by the President of the United States to the 
important position of Medical Inspector-General of the United 
States Army. On July 2d he received his promotion as surgeon, 
to date from April 16, 1862. 

Dr. Letterman, proceeding to the field of his new duties, 
arrived at the White House, on the Peninsula, on the 28th June, 
but, owing to the interruption of communications, was unable to 
report to General McClellan until July 1st, and was assigned to 
duty by him on July 4, 1862. 

The Army of the Potomac was then at Harrison's Landing, 
on the James River, whither it had retired after the exhausting 
Peninsula campaign. 

The service he had seen on the frontier and in Indian expedi- 
tions had inured him to the hardships of military life. It also 
gave him an intimate acquaintance with the personal needs and 



MEMOIR OF LETTERMAN. 3 

requirements of the soldier, which was now to be made available 
on a larger scale than had ever before been necessary in our 
country. 

The Army, exhausted by its conflicts, and the malarious at- 
mosphere of the Peninsula, was in great need of rest and recu- 
peration. The great loss of material of every kind that it had 
sustained, and the impaired health of the troops, demanded the 
highest qualities for its reorganization and re-equipment. 

General McClellan, in his report, says of the condition of his 
Army at this time : ' 

" The nature of the military operations had also unavoidably 
placed the Medical Department in a very unsatisfactory condi- 
tion. Supplies had been almost exhausted or necessarily aban- 
doned ; hospital tents abandoned or destroyed, and the medical 
officers deficient in numbers or broken down by fatigue." 

On his assignment to duty as Medical Director of the Army 
of the Potomac, he received from the Surgeon-General a letter 
of instructions which may be of interest at this day. 

" Surgeon-General's Office, 

"June 19, 1862. 
"Sir: 

" You are detailed for duty with the Army of the Potomac as Medi- 
cal Director. 

In making this assignment, I have been governed by what I con- 
ceive to be the best interests of the service. Your energy, determina- 
tion, and faithful discharge of duty in all the different situations in 
which you have been placed during your service of thirteen years, 
determined me -to place you in the most arduous, responsible, and trying 
position you have yet occupied. 

"On the eve of your departure I desire to place before you some of 
the main points which should engage your attention. 

" 1st. You should satisfy yourself that the medical supplies are in 
proper quantity and of good quality, and that each Regiment has its 
full allowance, and you will hold the senior medical officer to a strict 
accountability for any deficiency. The time has passed when the ex- 
cuse of ' no supplies ' will be accepted. 

" 2d. You will lay before the officers of the Quartermaster's Depart- 
ment your necessities in regard to transportation, and communicate 
freely with the General commanding, relative to those things in which 
he is able to assist you. 

1 Ex. Doc. No. 15, 38th Congress, ist session. 



4 MEMOIR OF LETTERMAN. 

" 3d. You will require all medical officers to be attentive and faith- 
ful in the discharge of their duties, and you will report instantly to the 
General commanding, and to this office, all cases of dereliction. 

" 4th. You will, in conjunction with Assistant Surgeon Dunster, 
U. S. A., Medical Director of Transportation, arrange for the safe, 
effectual, comfortable, and speedy transportation of such sick and 
wounded as in your opinion should be removed from the limits of the 
Army to which you are attached. You will bear in mind, however, the 
provision of General Orders No. 65, relative to the transportation of 
troops, and you will therefore, as far as possible, provide for those cases 
at such points in your vicinity as may seem best adapted to the pur- 
pose. 

"5th. You will hire such physicians, nurses, etc., as you may re- 
quire, and as you can obtain on the spot, making known to me imme- 
diately your deficiencies in that respect at the earliest possible moment, 
so that I can supply you. 

" For the full performance of all these duties, you are authorized to 
call directly upon the Medical Purveyors in Washington, Baltimore* 
Philadelphia, and New York, who will be directed to furnish you with 
every thing you may ask for, regardless of supply-tables or forms. You 
will only be required to notify me by letter what you have ordered, and 
of whom, and you are directed to correspond frequently with me, and 
to make known such wants as can only be filled by my requisitions on 
the several bureaus here or through the orders of the Secretary of 
War. 

"And now, trusting to your possession of those qualities, without 
which I should never have assigned you to the duty, I commit to you 
the health, the comfort, and the lives of thousands of our fellow- 
soldiers who are fighting for the maintenance of their liberties. 
" I am, Sir, very respectfully, 

" Your obedient servant, 
(Signed) " W. A. HAMMOND, 

" Ass't Surg., J. Letterman, " Surg.-Gen'l,U. S. A. 

" Medical Director. 

" Army of the Potomac." 



Dr. Letterman's attention was first directed to the removal 
from the Peninsula of the great number of sick, wounded, and 
broken-down men that trammelled the Army, to the enforcement 
of sanitary measures for improving and preserving the health of 
the troops, and to providing medical supplies. His recommenda- 
tions were brief, plain, and practical, and were enforced with 



MEMOIR OF LETTERMAN. 5 

energy. General McClellan, in his report already quoted, says : 
"All the remarkable energy and ability of Surgeon Letterman 
were required to restore the efficiency of his department; but 
before we left Harrison's Landing he had succeeded in fitting it 
out thoroughly with the supplies it required, and the health of 
the Army was vastly improved by the sanitary measures which 
were enforced at his suggestion." 

In the history of our country there were no precedents for the 
organization for war of a Medical Department which could be 
adapted to such numbers as were then engaged in conflict, and 
no aid was to be had from the study of the medical service of 
foreign armies, except such as the example of their dire ill suc- 
cess afforded. The Medical Departments of the British and 
French armies had broken down utterly in the Crimean War in 
the sight of the world, and the few weeks' conflict between 
France and Austria, on the historic plains of Lombardy, in 1859, 
had been too short to admit of the development of any system 
of organization other than the defective one with which the 
campaign was begun. 

In 1861 the French army was considered the model army of 
the world. Legouest, an experienced French military surgeon, 
in his work, " Chirurgie de 1' Arm£e," published a year after the 
Army of the Potomac left the Peninsula, writes of the objects 
desirable to be obtained in caring for the wounded ; but nowhere 
does he indicate what special means are to be adopted for their 
accomplishment, and he refers to the works of Larrey and Des 
Gennettes — surgeons with the first Napoleon, — and even to the 
ancient Par£ and Percy for information on those points. And 
after stating the fact that even the first succor to the wounded 
on the battle-field is not so simple an affair as at first sight ap- 
pears, continues (p. 984, 1st ed.) : 

" The removal of the wounded from the battle-field and their transpor- 
tation to the hospital is the most defective part of the medical service. 
Even now, after the great wars of the end of the last century and the be- 
ginning of the present, after the bloody battles of our own times, this 
important service (in the French army) is delegated to no particular 
person, or rather no one has been given authority or placed in position 
to render it. Military surgeons who have been present in various en- 
gagements all know that when the wounded fall in the ranks, there are 
none, as a matter of fact, to carry them off except their own comrades, a 
service as painful to one as to the other ; the soldier quits the ranks 



6 MEMOIR OF LETTERMAN. 

often never to return or only after the fight is over ; the number of men 
carrying off their comrades is rarely limited to the number really neces- 
sary, and one may sometimes see four, five, or even six soldiers conduct- 
ing to a hospital a man slightly wounded and marching quite as well as 
his comrades." 

In the French army during the Italian war of 1859 an a ^- 
tempt was made to prevent these abuses by forming brigades of 
stretcher-bearers composed of the musicians of each corps, but it 
was found wholly unreliable and impracticable. In our own 
armies no comprehensive system of caring for the sick and 
wounded had yet been devised. In the Army of the Potomac 
itself, the measures to this end were derived from the existing 
army regulations of 1861 ; the Quartermaster's Department was 
responsible for the transportation of the wounded and for the es- 
tablishment of the hospitals in an action. 1 

Perhaps no one in the responsible position of Medical Director 
of an army had ever before encountered more serious difficulties 
than did Dr Letterman's predecessor, Surgeon Charles Tripler, of 
the United States Army. Experienced in the war with Mexico, 
of military instincts and soldierly training, Dr. Tripler brought to 
this high duty the most untiring zeal and devotion to the interest 
of the soldier and the service. Delay and disappointment met 
him at every turn, as indeed was inevitable, for the whole army 
were alike inexperienced, and its appointments new and untried, 
and, above all, but few of the medical officers had any military 
training or habits. They shared with all other departments the 
misfortunes of inexperience." 

But the events of the Peninsular campaign had given to them 
all valuable experience and insight into the needs of the Medical 
Department. This experience made it apparent to this body of 
intelligent men, that a more comprehensive and practical system 
of caring for the sick and wounded than then existed, was still 
needed. 

The great need of an ambulance corps had long been felt. No 
thorough system for the management of ambulances had yet 
been devised, and without responsible organization, or a head to 
govern their use, they were inefficiently managed in time of bat- 
tle, and often diverted to improper purposes. 

1 See Circular, Head-quarters Army of the Potomac, Washington, March 7, 1862. 
' See " War of the Rebellion, Official Records of Union and Confederate Armies." Series I. 
vol. v, pages 76-112. 



MEMOIR OF LETTERMAN. 7 

It was at that time difficult to escape or break through the 
bonds which custom of service and military discipline had im- 
posed even upon the most experienced officers of the Regular 
Army. But these restraints were being removed ; the new head 
of the Medical Department of the United States Army, in disre- 
gard of precedent, gave extensive and independent authority to 
the officers of his corps, and especially to the Medical Director of 
the Army of the Potomac, for upon the condition of this Army 
at that time the attention of the whole country was directed. 

In Dr. Letterman were found the courage and the clear per- 
ception to devise and adapt a system for the organization of the 
Medical Department, which interfered in no manner whatever 
with the military authority of any commander, and which utilized 
in the most practical way the material at hand for this important 
service. 

Addressing himself at once to this serious task, amid the inces- 
sant labors of his new position, he, in a few weeks after joining 
the Army, drew up a plan for the organization of an Ambulance 
Corps, which was at once approved by General McClellan and 
published in General Orders dated August 2, 1862. 

The plan of organization devised by Dr. Letterman, placed 
in the Medical Director of the Army Corps under the General 
commanding it, the entire control of the ambulances. The Am- 
bulance Corps was divided into three divisions corresponding to 
the divisions of troops in each army corps, and all officers of 
every grade were forbidden to use ambulances or to permit them 
to be used for other than the purposes designated. 

The order permitted their use for transporting medical sup- 
plies in urgent cases, and eventually they were habitually used 
for transporting supplies to the brigades and thence to regiments. 

The men were detailed especially for their fitness for this ser- 
vice, and were taken from the regiments of the respective divis- 
ions. In the many schemes suggested by others to organize an 
ambulance corps, it was always proposed to enlist men specially 
for the purpose, but Dr. Letterman's knowledge of the service 
taught him how much better it was to take men who had already 
been drilled and disciplined, and who were identified with the 
regiments whose wounded they were to care for ; and as their 
duties in the Ambulance Corps would not exempt them from the 
dangers and exposure to which their regiments had to submit, 
the spirit of comradeship was thus kept up. 



8 MEMOIR OF LETTERMAN. 

Further mention of the details of this organization it is need- 
less to give here. The provisions of the order were embodied in 
the Act of Congress, approved so late as March, 1864, with some 
few changes. Dr. Letterman himself believed that the act was 
defective in making the number of ambulances and its necessary 
complement of men dependent on the number of men in a regi- 
ment. The number in the latter constantly varied and especially 
after a battle, and incessant and harassing changes were thus en- 
tailed. If the policy so strenuously urged by officers in the field, 
of filling up old regiments to the standard strength with new men, 
instead of forming new regiments, were adopted, the organization 
of the Ambulance Corps would be less liable to be frequently 
changing, and more stability would be secured. 

This act of Congress is based on the order written by Dr. Let- 
terman, devised by him and approved by General McClellan. 
It fortunately made a uniform system for every army in the field, 
but the student will miss from the act the precise details designat- 
ing specifically the practical work to be done by each and every 
one connected with it. It is most important that those details 
should be known to every member of the Ambulance Corps, and 
especially when a new army shall have to be formed. 

The Military Committe of the Senate submitted their original 
draft of the bill to Dr. Letterman for suggestions and recom- 
mendations ; he gave them in a brief and comprehensive way, 
suggesting a number of practical changes in the original bill, 
which he deemed of vital importance to the efficiency and disci- 
pline of the corps, all of which were adopted and incorporated in 
the bill, which finally became a law on March 11, 1865. It 
must excite surprise that such a law was not passed until more 
than two years after final and absolute proof of the perfect adap- 
tation of the system to the needs of the service had been given at 
the first battle of Fredericksburg, in December, 1862. 

No large opportunity, however, was given to test this plan 
during the transfer of the Army of the Potomac from the Penin- 
sula to Alexandria, Virginia. Dr. Letterman shared with Gen- 
eral McClellan the enforced inaction to which the head of the 
Army of the Potomac was for a while condemned at this critical 
period ; but when the latter was again placed in command of that 
gallant but dispirited army on the night of September 2, 1862, 
Dr. Letterman resumed control of its Medical Department. 

He found that the supplies were wofully deficient. In the 



MEMOIR OF LETTERMAN. 9 

rapid transfer of the army from the Peninsula, supplies and am- 
bulances had been left behind or lost, and medical officers and 
the officers of the Ambulance Corps were worn down by fatigue 
fro gi hard service. The deficiencies had to be made up while the 
Army was actually on the march into Maryland. Under these 
disadvantages the battle of Antietam was fought, but even then 
the great value of the new system of managing the ambulances 
was shown, and warranted great hopes of its future excellence. 

Some changes relating to the responsibility for the care of the 
material of the Ambulance Corps, which were of great impor- 
tance, as they rendered the Medical Department in a great meas- 
ure independent in its transportation, were made with the co-op- 
eration of the Chief Quartermaster in the fall of 1863 ; and some 
alterations and additions in the details were embodied in a revised 
ambulance order, dated August 24, 1863, but beyond these no 
change in its working was ever made in that army.' 

Very soon after the battle of Antietam, Dr. Letterman made 
another change of great importance in the method of supplying 
the Army with medicines, dressings, and medical material. The 
quantity of these materials carried was often excessive, and in 
other instances insufficient ; the mode of transporting them and 
of supplying them to the regiments was cumbrous and often un- 
reliable in time of battle. 

With that sagacity and practical knowledge of adapting means 
to ends which he possessed in so marked a measure, he reduced 
by careful selection the amounts of medicines and materials to be 
carried, lessened the number of wagons required to transport 
them to nearly one half the number previously in use, and gave 
simplicity, compactness, and efficiency to the whole service of 
supply. The details of this arrangement were published in a 
circular dated October 4, 1862, 3 and no material change in its 
requirements was ever found necessary, the completeness of the 
plan having been at once demonstrated. This circular was re- 
vised and republished September 3, 1863. 

Dr. Letterman now gave his attention to preparing a better 
method of providing for the care and treatment of the wounded 
in battle. It was not then known, nor is it now believed, that 
any precise system of Field Hospitals was then in use in any of 

1 This order will be given in an appendix to this " memoir," and will repay the careful atten- 
tion of the student. See Appendix I and IV. 
* Vide Appendix II. 



io MEMOIR OF LETTERMAN. 

our armies; but it was of the greatest importance that a system 
should be devised and made compulsory, by which every person 
should, beforehand, know what his duties were, and which should 
hold each one to a proper responsibility, whilst the most skilful 
surgeons should be available for the performance of operations 
on the field. 

On the 30th of October, 1862, while the Army of the Poto- 
mac was still in Maryland, he issued the important circular estab- 
lishing Field Hospitals and providing for all the details necessary 
for the prompt and efficient care of the wounded. It never re- 
quired change or alteration, and was in use until the Army of the 
Potomac was disbanded. This circular ' completed his scheme of 
organization of the Medical Department. Its provisions were 
adopted by the Surgeon-General of the Army, who, on March 
25, 1863, ordered its observance by all medical officers of the 
armies of the United States. 

It remained now to give practical effect to the working of this 
scheme of organization. The Ambulance Corps, the method of 
supply, and the Field-Hospital system were carefully designed to 
work as a whole. It is within the knowledge of the writer that 
the principal medical officers of the Army at once saw the sim- 
plicity of these measures, which also promised to increase the 
effectiveness of their own arduous labors in time of battle. The 
battle of Fredericksburg, in December, 1862, afforded the first 
opportunity to test whether they were to be successful. The act- 
ors in that dreadful conflict may themselves testify. 

Surgeon Charles O'Leary, then Medical Director of the Sixth 
Corps, now President of the State Medical Society of Rhode 
Island, said in his official report : 2 

" Being appointed Medical Director of the Sixth Corps a few days 
prior to the battle of Fredericksburg, December 13, 1862, I had the 
opportunity of putting in operation the Field- Hospital organization 
devised by the Medical Director of the Army, and witnessing its 
beneficial results. Within a very few hours after the positions were 
designated for the Field Hospitals on December 12th, all the necessary 
appliances were on hand, and the arrangements necessary for the 
proper care of the wounded were as thorough and complete as I have 
ever seen in a civil hospital. 

" During the engagements of the 13th, the ambulances being guided 

1 Vide Appendix III. 

a " Med. and Surg. History of the War," part i, Med. Vol., Appendix, page 134. 



MEMOIR OF LETTERMAN. 1 1 

and governed with perfect control and with a precision rare even in 
military organizations, the wounded were brought without any delay or 
confusion to the hospitals of their respective divisions. Not a single 
item provided for the organization of the Field Hospitals suffered the 
slightest derangement, and the celerity with which the wounded were 
treated, and the system pervading the whole Medical Department, from 
the stations in the field selected by the assistant-surgeons with the 
regiments, to the wards where the wounded were transferred from 
the hands of the surgeons to be attended by the nurses, afforded 
the most pleasing contrast to what we had hitherto seen during 
the war. * * * * * * * 

" Both military commanders and medical officers agree that it 
would have been impossible for wounded to have received better care 
and treatment than they did in that battle." 

A similar state of things characterized the operations of the 
Medical Department in the rest of the Army. 

In the operations at the time of the battle of Chancellors- 
ville in the following May, the Sixth Corps charged and took 
Marye's Heights behind the town of Fredericksburg. The 
Medical Director of the Corps, in his report {pp. cit., p. 138), 
says : 

"The charge was made at 1 p.m., the heights were taken, and in 
less than half an hour we had over 800 wounded. Two hours after the 
engagement, such was the celerity and system with which the ambu- 
lances worked, the whole number of wounded were within the hospitals 
under the care of nurses. ***** 

" Our hospital organization was strictly on the plan prescribed in 
the circular of the Medical Director of the Army. Supplies of every 
thing necessary were never for a moment deficient." 

It was not always that the exigencies of a battle permitted 
the use of all the means for the speedy care of the wounded that 
had been prepared with such labor and forethought. Such in 
fact was the case at the battle of Chancellorsville, in the Wilder- 
ness, where, despite Dr. Letterman's most urgent representations, 
but few ambulances and medicine wagons were allowed to come 
on the field ; and again for a time at the battle of Gettysburg, 
where for three days the issue hung in the balance. In the last- 
named battle the orders of the Commanding General had not 
only reduced materially the number of supply wagons for the 
Medical Department, but the exigencies of the closely contested 



12 MEMOIR OF LETTERMAN. 

conflict did not admit of those that were at hand being brought 
on the field. But the ambulance organization was intact, and 
such was the perfection of its administration, that on the early 
morning of 4th July, the day after the battle ended, not one 
wounded man of the great number who had fallen (over 14,000) 
was left on the ground. The Inspector-General of the Army 
himself reported this interesting fact from personal examination. 
No better example of the efficiency of the ambulance system 
than this and that already mentioned at the capture of Marye's 
Heights could be given. In this mighty battle of Gettysburg it 
fell out that for some reason not now known, in one corps of the 
Army, the Twelfth, no reduction in the number of supply 
wagons had been made, nor had any been sent to the rear 
as was the case in the rest of the Army, and its surgical 
organization was therefore intact. Its Medical Director, Surgeon 
McNulty, United States Volunteers, in referring to the working 
of the hospital organization, reported : ' 

" It is with extreme satisfaction that I can assure you that it enabled 
me to remove the wounded from the field, shelter, feed them, and dress 
their wounds within six hours after the battle ended, and to have every 
capital operation performed within twenty-four hours after the injury 
was received." 

A few more illustrations and proofs of the efficiency of the 
organization of the Medical Department of the Army of the 
Potomac will be given, drawn from official reports. Surgeon 
(now Brevet Brigadier-General) T. A. McParlin, United States 
Army, who in 1864 succeeded Dr. Letterman in that Army, in 
reporting his preparations for the campaign to Richmond in 
1864, referring to the ambulance law adopted by Congress in the 
spring of that year, says : 2 

" As its provisions corresponded in all essential particulars to the 
system already instituted in the Army by Surgeon Letterman, no diffi- 
culty or delay occurred in its adoption. * * * Tens of 
thousands of wounded men have been carefully, speedily, and safely 
transferred from the field of battle to the field hospitals, and from 
thence to the large depot hospitals, and this has been done without 
confusion, without hindering the movements of the Army, or conflicting 
with the operations of the other Staff Departments." 

1 " Medical and Surgical History of the War," part i, Med. Vol., Appendix, p. 141. 
1 Op. cit., p. 149. 



MEMOIR OF LETTERMAN. 13 

And of the Division Field Hospitals he says: "The Medical 
Staff of these hospitals was the same as established by Surgeon 
Letterman." And in beginning his report of his service in the 
Army as the successor of Dr. Letterman, he says : " The excellent 
condition of the Department at that period (January, 1864) 
evidenced the success of his labors." ' 

It is unnecessary to multiply commendations and instances of 
the thorough working of Dr. Letterman's system. 2 Such was its 
practical " common-sense " character that the Medical Officers of 
the whole Army vied with each other in carrying out its require- 
ments, and their intelligence and devotion to their duty and to 
their profession engendered among them a spirit of enthusiasm. 
The writer well remembers with what earnestness a most distin- 
guished Surgeon of Volunteers and Surgeon-in-chief of a Division, 
Holman, once said to him: "You can't imagine how deeply 
we all are indebted to Letterman for telling us what to do, and 
showing us how to do it." No higher commendation could be 
bestowed on Letterman's work, nor on the speaker's own devo- 
tion to his profession and the service. 

It came soon to be known that the Medical Officers of the 
Army of the Potomac could care for their wounded without the 
uncertain aid of surgeons and nurses from civil life. Before the 
battle of Chancellorsville, Dr. Letterman telegraphed the Sur- 
geon-General of the Army, at Washington, not to permit civilian 
surgeons to come to the field. He knew his corps could do the 
required work, and he desired to add to their self-reliance. For 
similar reasons he did not at this period, when his Department 
was in good working order, encourage the Sanitary Commission 
to apply their noble means of relief to the service of that Army. 
His confidence in his corps was well founded, for the wounded from 
that battle were treated, with the exception of a very small num- 
ber, in the Field Hospitals of their respective divisions which were 
established on the north side of the river, and it was observed by all 
that the wounded never before did so well after any great battle 
of that Army. The different Army corps vied with each other in 

1 Op. cit., p. 148. 

3 For illustration in more detail of the practical working of this organization the reader may- 
consult the following-named works. It is not intended here to do more than show its 
results. 

" Medical and Surgical History of the War of the Rebellion," Part I, Medical Volume 
and Appendix. 

Same. Part III, Surgical Volume, chap, xv : " Medical Recollections of the Army of the Po- 
tomac." D. Appleton & Co., New York. 



1 4 MEMOIR OF LETTERMAN. 

seeing to the comfort of their wounded ; the men were among 
their comrades and treated by their own surgeons ; their morale 
was maintained, and a great many speedily returned to the 
ranks who otherwise would not have rejoined in time for the next 
impending campaign. 

The knowledge of the ability of the Army in the field now to 
♦ take thoroughly good care of its wounded became eventually a 
source of great satisfaction to the country. A writer in a promi- 
nent Philadelphia newspaper, early in 1864, said, in drawing at- 
tention to the Medical Department of the Army of the Po- 
tomac : 

" The great and successful efforts which have been made by the 
Medical Department of the Army are known to but few outside of the 
Army. We have alluded to this subject in order that the friends and 
relatives of those who are now imperilling their lives in defence of 
their country may have some idea of what is doing by a humane and 
bountiful government for the relief of those who fall in its battles ; and 
that they may rest easy in the confident assurance that there is a depart- 
ment of the government which looks after the wounded and sick with 
the utmost care, and provides for all their wants. This Department is 
silently, and unostentatiously, and successfully working to alleviate the 
sufferings that must ensue after a battle ; and our people may rest 
assured that it will continue to take such care of the wounded and sick 
as has never before been done, either upon this continent or in the 
world." 

And at about the same time there appeared in a prominent 
medical journal in New York, the following remarks which aptly 
express the view then being taken of the results of Dr. Letter- 
man's labors. After giving a clear outline of the organization, it 
is said : 1 — 

"Whatever may be the future of the Army of the Potomac, it has 
gained a reputation for perfection of organization which will secure it a 
commanding position among the armies of history. 

******* 

"But the Medical Department has special claims upon the attention 
of the country. Without detracting from the merits of the other branches 
of the Army, we may say that the organization of the Medical Depart- 
ment has attained a degree of perfection which is found in no other 
army at home or abroad. It will be seen that the reforms were radical 

1 Med. Times, N. Y., April 30, 1864. 



MEMOIR OF LETTERMAN. 15 

and developed, under different heads, a system of operations which cov- 
ered the whole field of medical service. Its utility consisted in redu- 
cing to harmony and concert of action every branch of the medical ser- 
vice, and in placing the right man in the right place ; unity and 
efficiency was the key-note of the reform proposed, and to this every 
other consideration had to yield. The entire medical staff of the Army 
became a unit, and moved with the deliberation and precision of a 
single person. Of the practical value of these improvements we are 
now able to speak in the most unqualified terms. They have been put 
to the most rigid test, and have been found in the highest degree prac- 
tical and effective. The medical staff of no army ever worked in such per- 
fect harmony and subordination on the battle-field as that of the Army of 
the Potomac. The battles of South Mountain, Crampton's Gap, An- 
tietam, Fredericksburg, Chancellorsville, and Gettysburg, have placed 
the most violent strain upon every detail of this organization, whether 
taken as a whole or in its separate parts, and yet it has never been 
found wanting. The prompt care of the wounded in these sanguinary 
battles was never exceeded under similar circumstances. 

"The highest attestation of the value of the present organization of 
the ambulance service of the Army of the Potomac is found in the 
unanimity with which it has been pressed upon the attention of Con- 
gress, and the recent almost unanimous action of that body in extend- 
ing its provisions to all the armies of the United States. Its system of 
Field Hospitals has in the main also been adopted by the Surgeon-General 
for all our armies. 

" Too much praise cannot be awarded to Dr. Letterman for the 
patient and intelligent zeal with which he has labored to establish and 
perfect the present organization of the medical service of the Army of 
the Potomac. Its conception could only occur to a mind apt in method 
and organization, and while of comprehensive grasp, yet trained by 
experience to the study of details. * * * To Dr. Letterman is 
due the gratitude of the country for his perseverance in effecting these 
desired reforms." 

As time passed and officers and men became familiar with the 
workings of all its details, this system proved capable of im- 
provement in the direction of simplicity. 

Field Hospitals were organized for service even on the march; 
and in camp, and during periods of inactivity, it eventually be- 
came manifest that regimental hospitals were seldom necessary 
for the best interests of the sick — only the lighter and more 
trivial cases of disease and injury being treated in their regi- 
ments. 



1 6 MEMOIR OF LETTERMAN. 

This organization, it will be seen, was devised by Dr. Letter- 
man without aid from the experience of other armies ; it bore 
the test of the gigantic struggles of the great armies in Virginia, 
and the writer has failed of his purpose if he has not shown that, 
solely to Dr. Letterman's ability and his practical mind are due 
the conception and efficient working of this scheme, which pro- 
vided an Ambulance Corps for all our armies, added to the 
efficiency of the Army of the Potomac, and saved that Army 
from much of the inevitable suffering of war. 

It was not brought to its high state of efficiency without 
great and persistent labor, in which the Medical Directors of 
Corps and Divisions and the entire Medical Corps of that Army 
fully shared. Dr. Lettermann's admiration of his corps of sur- 
geons was great, and his confidence in them unbounded. Nearly 
all had come recently from civil life, and had entered upon novel 
and exacting duties without previous training ; but as soon as a 
plan was presented to them by which their sick and wounded 
could be cared for systematically, and their own great personal 
labors made to accomplish' speedy and effective results, they 
eagerly grasped at the opportunity, and on every battle-field of 
that great Army displayed professional and administrative ability 
and a devotion to their duties that Dr. Letterman omitted no op- 
portunity to recognize and commend. 

He well knew, and none knew better, how much of credit was 
due to the surgeons from civil life. He had the aid at different 
periods of his administration of some few able officers of the 
Regular Army of military training, To Alexander, Moore, Mil- 
hau, Wilson, of the Cavalry; Webster, Thompson, McMillan, 
and a few others of the Regular Medical Corps, he gave on all 
proper occasions the fullest meed of praise ; but to those of the 
Volunteer Staff and to the Regimental Surgeons he knew the 
actual results attained were mainly due. In his work entitled 
" Medical Recollections of the Army of the Potomac," he writes 
in the highest terms of praise of the services of the able volun- 
teers who shared with him the labors of his Department. He 
commended in brief and soldierly terms the services of O'Leary, 
Taylor, Dougherty, Heard, Pancoast, Janes, Holman, NcNulty, 
Oakley — and never omitted an opportunity to extol them. 

In a letter addressed to the Commanding General of the Army 
on the eve of the battle of Chancellorsville, he attributed the 
great improvement in the vigor and health of the troops " to the 



MEMOIR OF LETTERMAN. \J 

zeal and energy displayed by the Medical Directors of Corps and 
the Medical Officers of this Army generally, in inculcating the abso- 
lute necessity of cleanliness, and attention to the precautions for 
preserving the health of the troops," etc., etc., and he adds : " My 
directions and suggestions have been carried out with an intelli- 
gence and zeal which it affords me great satisfaction to bring to 
the notice of the Commanding General." 

The President of the United States was then visiting the 
Army, and expressed gratification at the favorable exhibit of the 
health of the Army and at the just praise bestowed on the Medical 
Officers. 

But the management of the Medical Department did not al- 
ways escape unfavorable criticism. On every battle-field suffering 
is inevitable, and, amid the excitement and seeming confusion only 
the practised and experienced eye can see the harmonious opera- 
tion of an extensive system. Many inexperienced persons repre- 
sented that on many battle-fields the wounded were not well cared 
for, yet such complaints scarcely ever were heard from the wound- 
ed. Straw to lie on, food and water, and the skilful attention of 
his surgeons, are all that the tried soldier desires or the experi- 
enced medical officer would demand on the battle-field ; yet there 
were at times even persons in authority, who, being ignorant of 
and inexperienced in the method of governing a vast establish- 
ment, were incapable of understanding the true meaning and 
significance of what appeared upon the surface of events on the 
battle-field. Some such at times would create misunderstanding 
and annoyance; but Utopian dreams of entire perfection have no 
place in the mind of the practised military man, and least of all 
did they find lodgement in the practical mind of Dr. Letterman. 

It seems probable that the changes which are being made in 
the method of conducting war in the future will involve altera- 
tions, in some degree, of the details of the plan of organization of 
the Medical Department of an army in the field that Dr. Letter- 
man devised and perfected ; but changes in its essential features 
are deemed unlikely to be required in this or the next generation, 
and any scheme radically different is not likely to be proposed. 
Its simplicity and tried adaptation to all emergencies of warfare 
must render its adoption inevitable. 

Whatever changes may be made in the future methods of 
warfare in this country, it may well be doubted if any Medical 
Corps will be willing to adopt the view expressed by a distin- 



1 8 MEMOIR OF LETTERMAN. 

guished officer of our Army, 1 that in future wars, "the sick and 
wounded will generally be sent to the rear, no longer to appear 
on the field during that war." 

No point was made more prominent, or considered more im- 
portant in Dr. Letterman's administration of the Army of the 
Potomac, than the necessity of treating the curable sick and the 
wounded in their own field-hospitals, in order that they might 
the sooner rejoin the ranks. 

A war would be brief indeed if some of the sick and wounded 
could not rejoin their colors before its termination, and the just 
pride of a medical corps, apart from other equally weighty con- 
siderations, would not readily tolerate a system which regarded 
all sick and wounded as no longer to be counted on for active 
service. 

It is not intended in this sketch to treat at length of the 
details of his administration. He put an end to the depleting of 
the ranks of the Army which had been caused by injudicious and 
careless discharges from the service, and by the license of sending 
unfit men to General Hospitals; and he insisted upon having the 
sick and the wounded treated in the Division Hospitals of their 
own Army Corps whenever the conditions of the military opera- 
tions permitted ; and by wise and practical sanitary measures, 
which were strenuously enforced, he kept that Army in a state of 
vigor and health altogether unparalleled in armies of its magni- 
tude. 

Amid the labor required to accomplish these results, he did 
not lose sight of the opportunities which the experience of the 
Army would afford of enlarging the then existing knowledge of 
military medical science, if it were properly recorded. The blank 
forms which he devised for this purpose were clear and compre- 
hensive, and they were filled up and kept by the Medical Officers 
with a degree of accuracy and care which could have been 
secured only in a well-organized and thoroughly disciplined 
Medical Department. There is i£& reason to believe that the 
medical and surgical records of the Army of the Potomac, which 
were continued and perfected by his distinguished successor, 
Surgeon T. A. McParlin (now Brevet Brigadier-General), U. S. A., 
are full and complete to an extent never before deemed attain- 
able. 

His orders and instructions, when the general plan of his 

1 Journal of Military Service Institution, vol. ii, No. 5, p. 8. 



MEMOIR OF LETTERMAN. 19 

management had become familiar to his assistants, were few and 
brief, and marked by a spirit of directness and practicability, and 
an intimate knowledge of the character of the soldier and the 
influences which affect him, as well as by the clearest conception 
of the needs of the service, in which the maintenance of the 
effective strength of the Army and of the vigor and spirit of its in- 
dividuals was never lost sight of. It is not too much to say that 
he succeeded in infusing into the officers of his Department much 
of the energy and directness of purpose which marked his own 
acts, and governed his conception of the duty of a Medical Officer 
of the Army. 

Dr. Letterman's claims to the grateful remembrance of his 
profession and of his countrymen, rest mainly upon the great 
services he rendered to his government in the Army of the 
Potomac, and the writer has therefore endeavored to present, in 
some detail, but as briefly as could be done, a plain account of 
the work he did and the results which were achieved by the 
Medical Department of that Army under the guidance of his 
practical and comprehensive mind. 

To him is justly due the praise of originating a system of 
medical administration which alleviated the sufferings and pre- 
served the lives of thousands of his countrymen, added to the 
vigor and effective fighting strength of the principal Army of the 
Republic, and materially aided in perfecting and maintaining its 
discipline; and which has had no equal in the armies of modern 
times for simplicity and effectiveness. 

For having done these things he has a just claim to the grate. 
ful remembrance of his professional brethren, of his military 
associates, and of his countrymen. 

In October, 1863, Dr. Letterman obtained a short respite 
from duty with the Army and married Miss Mary Lee of Mary- 
land, a highly accomplished lady, who was closely connected with 
some of the most prominent families of historic name in the 
adjacent States of Maryland and Virginia. On the occasion of 
his marriage he was presented, to his infinite surprise, with an 
elegant service of silver by the Medical Officers of the Army of 
the Potomac, with a note expressing feelings of great kindness 
to him. It was probably the first distinct intimation that he had 
ever received of the special regard entertained for him by that 
body of officers. In acknowledging its receipt he expressed the 
pride he felt in being an officer in that Army and his gratification 
at being so kindly regarded by its Medical Officers. 



20 MEMOIR OF LETTERMAN. 

When the Army of the Potomac went into winter-quarters 
after the military operations at Mine Run, Dr. Letterman, in 
December, 1863, requested the War Department to relieve him 
from duty with that Army with which he had so closely identi- 
fied himself. 

It was not known to even his intimate friends, and it can 
hardly concern those now living, why he took this step. He 
himself writes that it was evident no military movements could 
be made by either Army at that season ; "The Medical Depart- 
ment had been fully organized in all its branches ***** 
and little more remained to be done beyond the ordinary routine 
of duty." The labor and responsibility he had endured well 
entitled him to a respite ; he may have felt that other hands than 
his could now guide the instrument that he had so laboriously 
designed and perfected, and it may also be that some perception 
of failing health might have influenced his determination. But 
it caused the deepest regret to the Medical Officers when his in- 
tention to sever his connection with that gallant Army became 
known. 

The principal Medical Officers of the Army, at once and 
wholly unknown to him, united in'a "Memorial" to the Military 
Committee of the United States Senate urging, that he be honored 
with the rank and rewarded with the emoluments granted to the 
heads of other Staff Departments in the field, it being hoped 
that he might thereby be induced to rescind his resolution. This 
" Memorial " is in terms which constitute the highest commenda- 
tion that his co-laborers in the Medical Department could confer, 
and it is here given entire. 

" To the Covunittee of the Senate on Military Affairs : 

" Actuated purely by an interest in the welfare of the public service, 
and believing that the honorable body we address are actuated by the 
selfsame motive, being composed of men selected as the Nation's repre- 
sentatives for their zeal, their patriotism, their knowledge, and integrity, 
to watch over the military affairs in which now lies the Nation's life or 
ruin, to correct their abuses, to remedy defects, to inaugurate and en- 
courage improvement and efficiency in every department, — we beg to 
bring to their notice a subject, than which none other has, from its 
intrinsic importance, a stronger claim on their attention. 

"The Medical Department of this Army has, within the past year, 
approached to a degree of organization and perfection never attained 
even in the armies of those military powers where for centuries profes- 



MEMOIR OF LET TERM 'AN. 21 

sional skill, aided by experience of many wars, and encouraged by the 
patronage and the rewards of military rulers, has labored for its im- 
provement. We express not the sentiments of Medical Officers only ; 
we give the opinion of Military Commanders, when we affirm that not 
only the remarkable state of health, but in great measure the tone, the 
vigor, and in part the discipline of this Army, is due to the efficient 
officer at the head of its Medical Department. 

"When we contrast this Army at present, with what it was when 
Surgeon Letterman assumed the charge of its Medical Department, 
when the tide of men flowing to the rear depleted its ranks, owing to a 
lax system of discharges, or no system at all, and owing to an un- 
checked license of granting passes to hospitals ; when we compare the 
provisions now made for the wounded with what they were before his 
time, we cannot help congratulating the Army and the country upon the 
change, and cannot forbear bringing to your notice the merit of the 
officer to whom that change is due. 

" The Medical Department, without a head to guide it in the first 
campaign of this Army, between the complaints of the men, and the 
importuning solicitations of officers on every side, and without resources 
to provide for the sick, inclined universally to the only resource left, 
that of getting rid of every man who succumbed, or feigned to succumb, 
to the hardships of military life. 

" The Medical Officers saw and appreciated the evil, but were in their 
subordinate capacity helpless to remedy it. 

" The depletion of the Army by the great number sent to the rear 
has been stopped ; ample means provided and skilfully applied afford 
the sick all comfort necessary for their recovery within the lines. Sick- 
ness, by wise sanitary regulations, inculcated and rigidly enforced by 
constant vigilance, has been prevented from making its customary in- 
roads upon the strength of the Army. A system of ambulance has 
been devised, of the merits of which, and of its adaptation to all the 
vicissitudes of campaigns, we can adduce no stronger proof than that it 
has been embodied in a bill providing an Ambulance system for the 
Armies of the United States, by the Chairman of your Honorable Com- 
mittee. We may search history in vain for campaigns of equal severity, 
for battles of equal magnitude, with those of this Army for the past 
eighteen months, and we challenge history to produce a battle wherein 
the hundreds of wounded have been so well and so rapidly provided 
for, as the thousands in the great battles of this Army. 

" For the man who has benefited so much by his ability, by his un- 
tiring zeal, our Department, and in benefiting one has benefited each 
department of the Army, we ask or claim no extraordinary tribute, we 
merely represent for the sake of the Armies of the United States that he 



22 MEMOIR OF LETTERMAN. 

be honored with the rank and rewarded with the emoluments granted to 
the heads of other departments in the field, and that he be retained in 
his present position in order to complete successfully the organization 
he has devised, and to give the Government, the Country, and the Armies, 
the proof of its benefit in the practical success of its working. We make 
this appeal with feelings remote from personal considerations ; we make 
it because we believe the interests of the Service will be promoted by 
the measure we recommend ; we make it because we believe the 
Medical Department of the Armies of the United States will be thereby 
raised to the proud preeminence of being the most effective in any 
military organization of the world ; we make it because we believe, and 
in this belief we are seconded by the voice of every man within and 
without this Army, acquainted with its history, that he alone who has 
organized the Medical Department is the most competent to guide its 
practical working." 

This memorial was drawn up entirely without Dr. Letterman's 
knowledge, and was presented in person to Senator Wilson, then 
Chairman of the Military Committee of the United States Senate, 
who enthusiastically expressed his gratification at this evidence 
of the high esteem in which Dr. Letterman's services were held 
by his own Department, and he promised to use his earnest efforts 
before Congress to have its purpose effected ; but before any ac- 
tion could be taken Dr. Letterman had been relieved, and nothing 
further could therefore be done. 

When he was ordered to duty as Medical Director of the 
Army of the Potomac, he held the rank only of " Captain," 
though he soon after became, by regular promotion, a " Major." 
It will excite surprise that such a position should not entail a 
higher rank when the heads of all other Staff Departments in the 
field, in our own Army had much higher rank, and when in all 
other armies of modern times it is given only to officers of the 
highest grades. 1 

But, in obeying the orders of the War Department, he accepted 
the great responsibilities of the high position as he would have 
done the lightest that could have been imposed on him. He had 
not sought the position, and he was not consulted as to his detail 
for it. In a private letter written some time later he says: " I 
knew nothing of it until it was done. It was a position I did not 
seek; it was one I could not decline." He accepted it as a soldier 
should do, and he retired from it when his work was done ; but it 

1 In February 1865, Congress passed an Act giving higher rank and pay to Medical Directors. 



MEMOIR OF LETTERMAN. 23 

will ever be a great and lasting regret to his friends and comrades 
that he did not remain and inseparably link his name with his 
work, and with the glorious record of that grand Army until the 
consummation of its mission at Appomattox. 

On being relieved from duty with the Army of the Potomac, 
Dr. Letterman was assigned as Medical Inspector of Hospitals 
in the Department of the Susquehanna, in which position he re- 
mained until December, 1864. Flattering offers of a position as 
superintendent of a commercial company in Southern California, 
which afforded a prospect of highly lucrative gains, had been 
made him by Mr. Thos. A. Scott, then President of the Pennsyl- 
vania Railroad Company, and he was induced to resign from the 
Army. His Army friends strenuously endeavored to prevent 
him from taking this step, and even entreaty was used ; but he 
was not to be turned from his purpose, and his resignation from 
the Army was handed in and accepted by the President, to take 
effect December 22, 1864. He was twice recommended by Gen- 
eral McClellan for brevets for his services, and also by the Sur- 
geon-General, in March, 1863. 

The enterprise for which he had given up his commission as 
an officer of the Army that he had held for over fifteen years, un- 
fortunately did not fulfil the hopes of its originators, and Dr. 
Letterman retired from its management and took up his resi- 
dence in San Francisco, where he resumed the practice of his 
profession. 

In 1866, whilst engaged in Southern California, he prepared 
and published an account of his administration of the Medical 
Department of the Army of the Potomac. This work is entitled 
" Medical Recollections of the Army of the Potomac." At the 
time of its publication the country was resting under the reaction 
following the great and exhausting war, and interest in its events 
had not yet been revived, and in consequence this work has not 
attracted the attention that, in the opinion of the writer, it well 
deserves. It is replete with practical observations of the highest 
value, and in recounting the medical history of the different bat- 
tles of that Army, he has made a valuable contribution to the 
science and art of military administration. In it he refers, often 
in ardent terms, to the services rendered by his medical col- 
leagues. In his preface he says it was " prepared amidst press- 
ing engagements in the hope that the labors of the Medical Offi- 
cers of that Army may be known to an intelligent people, with 



24 MEMOIR OF LETTERMAN. 

whom to know is to appreciate, and as an affectionate tribute to 
many — long my zealous and efficient colleagues — who, in days 
of trial and danger which have passed, let us hope never to re- 
turn, evinced their devotion to their country and to the cause 
of humanity, without hope of promotion or expectation of 
reward. 1 

In the autumn of 1867, he was elected Coroner of the City 
and County of San Francisco, an office understood to be very 
lucrative ; but before he entered upon its duties, a great and 
lasting affliction fell upon him in the sudden death of his de- 
voted wife on November 1, 1867. 

Under the weight of this great sorrow, he entered upon the 
duties of his new office, but with his usual energy and resolution, 
he performed them so satisfactorily that he was re-elected to the 
office for another term, on the expiration of which, on December 
4, 1 871, he retired to private life. 

He had been commissioned, in 1868, by Governor Haight, as 
Surgeon-General of the State of California. In 1870, the Regents 
of the University of California elected him a member of the 
Board of Medical Examiners of that university, and in 1871 he 
was made a member of the first class of the Military Order of 
Loyal Legion of the United States. 

But the dark shadow of his domestic affliction never passed 
away from his noble spirit ; his health, already seriously impaired 
by long existing chronic disease of the intestines, became very 
precarious. 

On March 13, 1872, — but a few months after retiring from the 
office of Coroner, — he became very ill, and was visited by Dr. 
A. S. Ferris, of San Francisco, and by Dr. Wm. Hammond, an 
old friend and former colleague in the Army. As soon as it be- 
came known that he was seriously ill, troops of friends hastened 
to his side; his exhaustion rapidly increased, and, though he 
received every attention that skill and devoted friendship could 
bestow, he sank and died on March 15, 1872. 

His remains were removed to St. Mary's Cathedral, in the 
city of San Francisco, where the last rites of his church were 
celebrated, and thence were escorted by the members of the 
Loyal Legion and a body of distinguished officers of the Army 
and Navy, to Lone Mountain Cemetery, near that city, and laid 

1 " Medical Recollections of the Army of the Potomac," by Jonathan Letterman, M.D. D. 
Appleton & Co., New York. 



MEMOIR OF LETTERMAN. 25 

to rest. At his death he was forty-seven years and a few months 
old. 

Dr. Letterman's character was of such simplicity that no ex- 
tended phrases are required to do it honor. His directness of 
speech and manner expressed the frankness and sincerity of his 
nature. Of a truly modest disposition, he possessed great kind- 
ness of heart and sensibility to the feelings of others, and he 
united to these endearing qualities the keen sense of humor that 
so often accompanies them. Unselfish himself, he was generous 
in according praise to his colleagues, and his guiding thought 
was to do his whole duty, whatever it might be, as thoroughly as 
he could do it. A true friend to all who gained his confidence, 
he was unswerving in his devotion to the right, and it may be 
truly said of him that he was an honest man in thought and in 
deed. 

An interesting reminiscence of his earliest service in the 
Army has recently been given by a distinguished officer. 

Military service on the frontier, in the days when railroads 
were not, brought men into intimate association ; the common 
dangers and exposure, and the isolation from civilization, gave 
prominence to every trait of character, and brought, into relief 
the virtues and the filings of every one. Enduring friendships 
were formed in those days now passed, a pleasing illustration of 
which the writer is able to present, through the kindness of a 
friend, in the following graceful tribute to Dr. Letterman's 
memory, from General W. W. Loring, under whom he served 
when the latter was Colonel of the Regiment of Mounted Rifles 
of our Army when Dr. Letterman entered the service, and who 
later held high rank in the Egyptian Army of the Khedive. 

" No. 9 Waverley Place, New York. 

" Nov. 27, 1882. 
" Dr. I. Cooper M'Kee, 

" U. S. Army. 

" Dear Doctor : — I recollect our old friend Dr. Letterman with 
great affection. * * * For several years we served together at Fort 
Union, New Mexico, where there was stationed the larger portion of my 
old regiment, and I always had reason to be thankful that we were favored 
by a gentleman of such equable temperament and such skill in his profes- 
sion. I never knew an officer who was all the time more ready to act at 
the call of duty ; full of manly sympathy, he was ever ready to render 



26 MEMOIR OF LETTERMAN. 

timely aid to the suffering, whether at the summons of an officer or the 
call of the private soldier. 

" These and his many virtues endeared him to the entire command. 
Socially, he was modest and retiring, gentle, almost childlike in his 
character. No one who had the pleasure of knowing him but formed a 
very high estimate of his ability, and (though comparatively young at 
that time) of his varied experience. 

" From my close intimacy with him, I became aware that he was an 
ardent student, and no man in his corps sought more earnestly to attain 
the highest knowledge in the scientific advancement of his profes- 
sion. 

" I have hastened to send you this short note, and to add, though 
slight, my respectful homage in remembrance of a generous and true- 
hearted gentleman ; and though our fortunes were in opposite direc- 
tions, I have never ceased to look back to our early acquaintance on 
that distant frontier service, as one of the pleasant episodes in my life, 
and, as you may conceive, I recall the many incidents connected with it 
to make green in my memory one of those who was without guile, and 
who never did an intentional wrong to any man. 

" With kindly regard, truly, 
(Signed) " W. W. LORING." 



The friends and comrades of Dr. Letterman in the Army of 
the Potomac will read with special gratification the following note 
from his old and beloved commander, General McClellan, which 
expresses in generous terms his appreciation of Dr. Letterman's 
services and character. 1 

" Washington, Febry 26, 1883. 
" Gen'l Chas. H. Crane, 

"Surgeon-General U. S. A. 

" My Dear General : — I have read with the greatest interest Dr. 
Clements' memoir of our old friend Letterman. 

" It recalled in all its freshness the memory of those trying days 
during which it was my good fortune to have him at my side as the 
Chief Medical Officer of the Army of the Potomac. He joined me in 
the midst of the cares inseparable from the close of a week of contin- 
uous battle. 

" Thousands of sick and wounded were to be cared for with insuf- 
ficient means. 

1 The manuscript of this paper, through the kindness of the Surgeon-General of the Army, was 
submitted to General McClellan, who returned it with the note given in the text. 



MEMOIR OF LETTERMAN. 27 

" I saw immediately that Letterman was the man for the occasion, 
and at once gave him my unbounded confidence. In our long and 
frequent interviews upon the subject of his duties, I was most strongly im- 
pressed by his accurate knowledge of his work — the clear and perfectly 
practical nature of his views and the thorough unselfishness of his char- 
acter. He had but one thing in view — the best possible organization of 
his Department — and that, not that he might gain credit and promotion 
by the results of his work, but that he might do all in his power to 
diminish the inevitable sufferings of the soldiers and increase the 
efficiency of the Army. 

" I never met with his superior in power of organization and execu- 
tive ability. 

" It is a great satisfaction to me to be able once more to bear testi- 
mony to my intense gratitude for the services he rendered to the Army 
under my command, and my admiration for his high qualities as an 
officer and man. 

" Very sincerely, your friend, 

"GEO. B. McCLELLAN." 

The writer of this paper, though honored with the friendship 
of Dr. Letterman, and intimately associated with him in his 
administration of the Medical Department of the Army of the 
Potomac, would gladly have left to abler hands the grateful task 
of endeavoring to rescue from oblivion the record of his able, 
faithful, and useful services. 

But there seemed to be no other one to render to his memory 
this last office of justice and of friendship; and he presents this 
memoir, however inadequate it may be, to the Army, to the 
Medical Profession, and especially to the surviving Medical 
Officers of the Army of the Potomac, as a tribute due to the 
memory of a most faithful officer, who devoted his great talents 
and all his energy to the welfare of the men of that Army, and to 
the honor of his profession and of his corps. 



28 MEMOIR OF LETTERMAN. 



APPENDIX. 



i. 



AMBULANCE CORPS. 



HEAD-QUARTERS, ARMY OF THE POTOMAC, 

August 24, 1863. 

General Orders, ) 
No. 85. \ 

The following revised regulations for the organization of the Ambulance Corps, 
and the management of the Ambulance Trains, are published for the government of all 
concerned, and will be strictly observed : 

1. The Army Corps is the unit of organization for the ambulance corps, and the 
latter will be organized upon the basis of the Captain as the commandant of the corps, 
one 1st Lieutenant for each division, one 2d Lieutenant for each brigade, one Sergeant 
for each regiment. 

2. The Privates of this corps will consist of two men and one driver to each 
amoulance, and one driver to each medicine wagon. 

3. The two-horse ambulances only will be used, and the allowance, until further 
orders, to each corps, will be upon the basis of three to each regiment of infantry, two 
to each regiment of cavalry, one to each battery of artillery, to which it will be per- 
manently attached, and two to the head-quarters of each army corps, and two army 
wagons to each division. Each ambulance will be provided with two stretchers. 

4. The captain is the commander of all the ambulances, medicine and other 
wagons in the corps, under the immediate direction of the Medical Director of the 
Army Corps to which the ambulance corps belongs. He will pay special attention to 
the condition of the ambulances, wagons, horses, harness, etc., and see that they are at 
all times in readiness for service ; that the officers and men are properly instructed in 
their duties, and that these duties are performed, and that the regulations for the corps 
are strictly adhered to by those under his command. He will institute a drill in his 
corps, instructing his men in the most easy and expeditious method of putting men in 
and taking them out of the ambulances, lifting them from the ground and placing and 
carrying them on stretchers, in the latter case observing that the front man steps off 
with the left foot and the rear man with the right, etc. ; that in all cases his men treat 
the sick and wounded with gentleness and care ; that the ambulances and wagons are 
at all times provided with attendants, drivers, horses, etc. ; that the vessels for carry- 
ing water are constantly kept clean and filled with fresh water ; that the ambulances 
are not used for any other purpose than that for which they are designed and ordered. 
Previous to a march he will receive from the Medical Director of the Army Corps his 



MEMOIR OF LETTERMAN. 29 

orders for the distribution of the ambulances for gathering up the sick and wounded 
previous to, and in time of, action ; he will receive orders from the same officer where 
to send his ambulances, and to what point the wounded are to be carried. He 
will give his personal attention to the removal of the sick and wounded from the field 
in time of action, going from place to place to ascertain what may be wanted ; to see 
that his subordinates (for whose conduct he will be responsible) attend faithfully to 
their duties in taking care of the wounded, and removing them as quickly as may be 
found consistent with their safety to the field hospital, and see that the ambulances 
reach their destination. After every battle he will make a report, in detail, of the 
operations of his corps to the Medical Director of the Army Corps to which he 
belongs, who will transmit a copy, with such remarks as he may deem proper, to 
the Medical Director of this Army. He will give his personal attention to the re- 
moval of sick when they are required to be sent to general hospitals, or to such other 
points as may be ordered. He will make a personal inspection, at least once a month, 
of every thing pertaining to the ambulance corps, a report of which will be made to the 
Medical Director of the Corps, who will transmit a copy to the Medical Director of 
this Army. This inspection will be minute and made with care, and will not super- 
sede the constant supervision which he must at all times exercise over his corps. He 
will also make a weekly report, according to the prescribed form, to the same officer, 
who will forward a copy to the Medical Director of this Army. 

5. The 1st Lieutenant assigned to the ambulance corps for a division, will have 
complete control, under the captain of his corps and the Medical Director of the Army 
Corps, of all the ambulances, medicine and other wagons, horses, etc., and men in that 
portion of the ambulance corps. He will be the Acting Assistant Quartermaster for 
that portion of the corps, and will receipt and be responsible for all the property 
belonging to it, and be held responsible for any deficiency in any thing appertaining 
thereto. He will have a travelling cavalry forge, a blacksmith, and a saddler, who will 
be under his orders to enable him to keep his train in order. His supplies will be 
drawn from the depot Quartermaster, upon requisitions approved by the captain of his 
corps, and the Commander of the Army Corps to which he is attached. He will 
exercise a constant supervision over his train in every particular, and keep it at all times 
ready for service. Especially before a battle will he be careful that every thing be in 
order. The responsible duties devolving upon him in time of action, render it neces- 
sary that he be active and vigilant and spare no labor in their execution. He will 
make reports to the captain of the corps, upon the forms prescribed, every Saturday 
morning. 

6. The 2d Lieutenant will have command of the portion of the ambulance corps 
for a brigade, and will be under the immediate orders of the commander of the ambu- 
lances for a division, and the injunctions in regard to care and attention and super- 
vision prescribed for the commander of the division he will exercise in that portion 
under his command. 

7. The Sergeant will conduct the drills, inspections, etc., under the orders and 
supervision of the commander of the ambulances for a brigade, be particular in 
enforcing all orders he may receive from his superior officer, and that the men are 
attentive to their duties. 

The officers and non-commissioned officers will be mounted. The non-commis- 
sioned officers will be armed with revolvers. 

8. Two Medical Officers, and two Hospital Stewards will be detailed, daily, by 
roster, by the Surgeon-in-Chief of Division, to accompany the ambulances for the Divi- 
sion, when on the march, whose duties will be to attend to the sick and wounded 
with the ambulances, and see that they are properly cared for. No man will be per- 



30 MEMOIR OF LETTERMAN. 

mitted, by any line officer, to fall to the rear to ride in the ambulances, unless he has 
written permission, from the senior Medical Officer of his regiment, to do so. These 
passes will be carefully preserved, and at the close of the march be transmitted, by 
the senior Medical Officer with the train, with such remarks as he may deem proper, 
to the Surgeon-in-Chief of his Division. A man who is sick or wounded, who requires 
to be carried in an ambulance, will not be rejected, should he not have the permission 
required ; the surgeon of the regiment who has neglected to give it, will be reported 
at the close of the march, by the senior surgeon with the train, to the Surgeon-in- 
Chief of his Division. When on the march, one half of the privates on the ambulance 
corps, will accompany, on foot, the ambulances to which they belong, to render such 
assistance as may be required, The remainder will march in the rear of their respect- 
ive commands, to conduct, under the order of the Medical Officer, such men as may 
be unable to proceed to the ambulances, or who may be incapable of taking proper 
care of themselves until the ambulances come up. When the case is of so serious a 
nature as to require it, the surgeon of the regiment, or his assistant, will remain and 
deliver the man to one of the Medical Officers with the ambulances. At all other 
times the privates will be with their respective trains. The medicine wagons will, on 
the march, be in their proper places, in the rear of the ambulances for each brigade. 
Upon ordinary marches, the ambulances and wagons belonging to the train will follow 
immediately in the rear of the division to which it is attached. Officers connected 
with the corps must be with the train when on the march, observing that no one rides 
in any of the ambulances except by the authority of the Medical Officers. Every 
necessary facility for taking care of the sick and wounded upon the march will be 
afforded the Medical Officers by the officers of the ambulance corps. 

9. When in camp, the ambulances will be parked by divisions. The regular 
roll-calls, reveille, retreat, and tattoo, will be held, at which at least one commissioned 
officer will be present and receive the reports. Stable duty will be at hours fixed 
by the captain of the corps, and at this time, while the drivers are in attendance upon 
their animals, the privates will be employed in keeping the ambulances to which they 
belong in order, keeping the vessels for carrying water filled with fresh water, and in 
general police duties. Should it become necessary for a regimental Medical Officer to 
use one or more ambulances for transporting sick and wounded, he will make a requi- 
sition upon the commander of the ambulances for a division, who will comply with 
the requisition. In all cases when the ambulances are used, the officers, non-commis- 
sioned officers, and men belonging to them, will accompany them ; should one ambu- 
lance only be required, a non-commissioned officer as well as the men belonging to it, 
will accompany it. The officers of the ambulance corps will see that ambulances 
are not used for any other purposes than that for which they are designed, viz. : the 
transportation of sick and wounded, and in urgent cases only, for medical supplies. 
All officers are expressly forbidden to use them, or require for them to be used, for any 
other purpose. When ambulances are required ,for the transportation of sick or 
wounded at Division or Brigade Head-quarters, they will be obtained, as they are 
needed for this purpose, from the Division train, but no ambulances belonging to this 
corps will be retained at such Head-quarters. 

10. Good, serviceable horses will be used for the ambulances and medicine 
wagons, and will not be taken for any other purpose except by orders from these 
Head-quarters. 

11. This corps will be designated for Sergeants, by a green band one and one 
quarter inches broad around the cap, and chevrons of the same material, with the 
point toward the shoulder, on each arm above the elbow. For Privates, by a band 
the same as for Sergeants around the cap, and a half chevron of the same material on 
each arm above the elbow. 



MEMOIR OF LETTERMAN. 3 I 

12. No person except the proper Medical Officers, or the officers, non-commis- 
sioned officers, and privates of this corps, will be permitted to take or accompany 
sick or wounded to the rear, either on the march or upon the field of battle. 

13. No officer or man will be selected for this service except those who are 
active and efficient, and they will be detailed and relieved by Corps Commanders 
only. 

14. Corps Commanders will see that the foregoing regulations are carried into 
effect. 

By command of Major-General Meade: 

S. WILLIAMS, 

Assistant Adjutant General. 



II. 



SUPPLY TABLE FOR THE MEDICAL DEPARTMENT OF THE ARMY 
OF THE POTOMAC. 

HEAD-QUARTERS ARMY OK THE POTOMAC, 

Medical Director's Office, 

September 3, 1863. 

[circular.] 

The following table of supplies for the Medical Department of this Army is pub- 
lished, instead of the one contained in the Circular from this office of October 4, 1862. 

Experience has more fully shown the expediency of the manner of supplying this 
Department, as ordered by the Circular referred to, and it will be kept up. 

There will be allowed, in the Army of the Potomac, the following supplies to a 
Brigade for one month, for active field service, viz. : 

One Medicine Wagon, filled. 

One Medicine Chest for each Regiment, filled. 

One Hospital Knapsack for each Regimental Medical Officer, filled. 

Supplies in the list marked "A," which will be carried in an ordinary Army 
wagon. 

The Surgeon-in-Chief of each Brigade will require and receipt to the Medical 
Purveyor for all these supplies, and will issue to the senior Medical Officer of each 
Regiment in his Brigade the Medicine Chest and Knapsacks, taking his receipt there- 
for. The Wagons, both Medicine and Army, will be receipted for by the Ambulance 
Quartermaster. 

The Surgeons-in-Chief of Brigades will issue to Regimental Medical Officers such 
of the supplies from the Medicine or Army Wagon as may from time to time be 
required. These issues will be informal, the Surgeons-in-Chief giving no invoices, 
demanding no receipts, but accounting for them as expended. At the same time they 
will be particular that no improper expenditure or wastage is permitted. These 
officers are especially directed, when they shall have drawn the monthly supply, not to 
divide it out among the Regiments, but only to issue the articles at such times and in 
such quantities as they are needed for use, or to keep the Medicine Chests and Knap- 
sacks supplied. 

Requisitions will be made in duplicate, and in strict conformity With this table ; 
and in all cases the articles will be enumerated in the order in which they occur in it. 



32 



MEMOIR OF LETTERMAN. 



Supplies will only be issued by the Medical Purveyor upon requisitions approved by 
Medical Directors of Corps, and these officers are particularly enjoined to revise all 
requisitions with care, that sufficient supplies may be on hand, and yet that no 
unnecessary expenditure be permitted. As far as possible, requisitions will be made 
but once a month, and special requisitions avoided as far as practicable. 

The supply allowed will be kept up, and Medical Directors will see, especially 
before a march or a battle, that timely requisitions are made, and the supplies 
obtained. 

In all ordinary cases, the amount on hand at the time the requisition is made, will 
be given, as well as the amount required, and requisitions will be made only for such 
articles, and in such amounts, as may be necessary to fill up the Brigade Supply to the 
amount ordered to be kept on hand. 

Should the welfare of the sick demand a greater amount than is given by this 
table, or for articles which are not allowed by it, the reasons therefor must be fully 
and clearly stated, and the requsitions approved at this office. The Medical Purveyor 
will keep on hand only such articles as are contained in this table. 

Instruments, except such as are enumerated in this table, will be issued only upon 
requisitions approved at this office. 

When articles, such as Instruments, Medicine Chests, are from any cause unser- 
viceable, they will not be turned in to the Medical Purveyor, unless inspected and 
ordered to be disposed of in accordance with the instructions contained in General 
Order No. 37, Head-quarters of Army of the Potomac, April 2, 1863. Whenever it 
becomes necessary, from any other cause, to turn in supplies to the Medical Purveyor, 
application, with the reasons therefor, will be made to this office. 

One Knapsack will be carried, in each Regiment, when on the march, by a 
Hospital Nurse. 



ARTICLES. 



In Medicine 
Wagon. 



[A.] 



In Army 
Wagon. 



Acacias pulvis 

Acid : sulphuricum aromat 

" tannic : 

" tartaricum 
^Ether sulphuric : . 

" spirit : comp : . 

" " nitrici 

Alcohol 
Alumen 

Ammonia; carbonas 
" liquor 
" spirit : aromat : 
Argenti nitras 

'' fusum 
Bismuth subnitras . 
Camphora 

Cantharidis ceratum 
Capsici pulvis . 
Cera alba . 
Ceratum adipis 
" resinse 
Cinchonias sulphas 
Chloroformum, (in 8 oz. bo 
Collodium 



ties.) 



Oz. 



Botts. 
Oz. 



Lb. 
Oz. 



16 
32 
12 



24 
32 

I 



Oz. 



32 Oz. 

4 

1 
1 
16 
8 
S 
8 
4 i 
3 Lb. 



Oz. 



32 
16 
32 



64 
16 



192 



MEMOIR OF LETTERMAN. 



33 









[A.] 




ARTICLES. 


In Medicine 
Wagon. 


In Army 
Wagon, 


Copaiba ...... 


Oz. 


32 






Creosotum 








" 


4 






Cupri sulphas 












" 


2 






Extractum aconiti rad : fluidum 












' ' 


4 






" belladonnas 












" 


1 






" cinchona; fluidum 












" 


16 






" colchici sem : fluid : 












" 


4 






" colocynthidis comp : 












" 


8 






" ipecachuanas fluid : 












" 


8 






" senegas fluid : 












" 


8 






" zingiberis fluid : 












" 


16 






Ferri chloridi tinctura 












" 


8 


Oz. 


16 


" et quinias citras 












" 


1 






" persulphatis liquor 












" 


4 






" " pulvis 












* * 


1 


Oz. 


16 


Glycerina 












" 


8 






Hydrargyri pilulas . 












" 


8 


Oz. 


16 


" unguentum 












Lb. 


1 






" " nitratis 












Oz. 


4 






Hydrargyrum c. creta . 












" 


8 






Iodinum 












" 


2 






Ipecachuanas et opii pulvis 












" 


8 


Oz. 


48 


Ipecachuanas pulvis 












Oz. 


8 






Lini pulvis 












Lb. 


8 






Magnesias sulphas . 












" 


8 


Lb. 


16 


Morphias " ... 










Oz. 


i 


Oz. 


4 


Oleum olivas, (in 32 oz. bottles.) 










Botts. 


2 


Botts. 


4 


" ricini " " 










" 


4 


" 


4 


" terebinthinas, " " 










" 


1 






" tiglii .... 










Oz. 


1 






Opii pulvis 










" 


8 


Oz. 


16 


" tinctura .... 










' ' 


16 






" " camphorata 










" 


16 


Oz. 


32 


Pilulas camphoras (gr. 2) et opii (gr. 1) 










Doz. 


8 


Doz. 


8 


" cathart : comp : 










' * 


8 


" 


24 


" opii .... 










* * 


8 


" 


24 


Plumbi acetas 










Oz. 


8 


Oz. 


32 


Potassas arsenitis liquor 










" 


8 






" bicarbonas . 










" 


8 






" chloras 










" 


8 


• < 


32 


" permanganas, (crystals.) . 










" 


2 






Potassii iodidum 










" 


8 


" 


32 


Quinias sulphas 










10 


" 


4 S 


" " (in pills, 3 grs. each.) . 










Doz. 


8 


Doz. 


24 


Sapo .... 










Lb. 


8 


Lb. 


4 


Scillas syrupus 










" 


4 


" 


4 


Sinapis nigras pulvis 










" 


6 


" 


6 


Sodas chlorinat : liq : (in one pound bottles 


•) 








" 


1 


" 


6 


" bicarbonas .... 










Oz. 


S 


Oz. 


64 


" et potassas tartras 










" 


16 






Spiritus frumenti . 










Botts. 


24 


Botts. 


24 


" vini gallici 










" 


6 


" 


24 


Sulphur .... 
Zinci chloridi liquor 














Oz. 


32 
96 










Oz. 


16 


" sulphas 














2 





34 



MEMOIR OF LETTERMAN. 



ARTICLES. 



In Medicine 
Wagon. 



[A.] 

In Army 
Wagon. 



HOSPITAL STORES. 



Beef stock, (2 pound cans.) 

Candles, sperm 

Farina 

Nutmegs 

Sugar, white 

Tea, black . 

Milk . 



INSTRUMENTS 



Buck's sponge-holder 
Cupping tins . 
Lancets, thumb 
Pocket case 
Probangs 
Scarificators 
Scissors 
Stethoscopes 
Syringes, self-injecting 
" enema, 16 oz. 
Syringes, penis (glass) . 
" " (rubber) 

Teeth-extracting instruments 
Tongue depressor (hinged) 
Tourniquets, field 

screw 
Trusses 



DRESSINGS, ETC 



Adhesive plaster 

Binder's board, (2^ by 12 inches) 

4 by 17 " 
Cotton bats 

" wadding 
Flannel, red 
Gutta-percha cloth 
Ichthyocolla plaster 
Lint, patent 

" scraped . 
Muslin 
Needles, 25 ; cotton 



, 1 spool ; 



Oiled muslin 

" silk 
Pencils, hair 
Pins 

Roller bandages, assorted 
Silk, green (for shades) 

" surgeon's 
Splints . 

" Smith's anterior 
Sponge, fine 
Suspensory bandages 
Tape 

Thread, linen 
Tow 
Towels 
Twine . 



thimbles 




No. 


1 


* ' 


12 


" 


2 


Case 


1 


No. 


12 


' ' 


2 


" 


2 


" 


1 




1 



No. 

Case 
No. 



Yds. 
Pieces 

No. 

Sheet 

Yds. 



Lb. 

Yds. 
No. 
Yds. 

No.' 

Papers 

Doz. 

Yd. 

Oz. 

Set 

Oz.' 

No. 
Pieces 

Lb.' 
Doz. 
Oz. 



No. 

No. 



Yds. 
Pieces 

No. 



Yds. 
Lb. 



5 
4 

10 i Yds. 

1 J 

12 

2 
16 

1 

1 



Yds. 

Papers 
Doz. 

Oz. 
Sets 
No. 
Oz. 
No. 

Oz. 

Doz. 



4 S 
12 
10 



10 
12 



4 



20 

48 

4 S 

4 



IO 

20 
24 



4 
100 

4 

4 

10 

16 

16 



MEMOIR OF LETTERMAN. 



35 









[A.] 




ARTICLES. 


In Medicine 
Wagon. 


In Army 
Wagon: 


BOOKS, ETC. 










U. S. Dispensatory .... 


Copy 








Surgery, Erichsen's ..... 


" 








" Smith's Handbook 


" 








" Sargent's Minor .... 


" 








Gun-shot wounds — Longmore 


" 








Blank books ...... 


Copies 




Copies 


8 


" " quarto .... 


No. 








Case book ...... 


No. 








Register of patients .... 


No. 








Order and letter book .... 


No. 








Requisitions, returns, and reports 


No. 








Ink (2-oz bottles) ..... 


No. 


2 


No. 


S 


Inkstand, portable ..... 


" 


I 






Envelopes .....: 


" 


IOO 


No. 


IOO 


Paper, wrapping, white and blue . 


Quires 


2 


Quires 


2 


" writing ...... 


" 


4 


Quires 


8 


Pencils, lead ..... 


No. 


6 






Pens, steel, with holders .... 


" 


12 


No. 


48 


Portfolio ...... 


" 


1 






Sealing wax ...... 


Stick 


1 






Mucilage ...... 


Bot. 


1 






BEDDING, ETC. 










Blankets ...... 

Blanket cases ..... 


No. 


20 


No. 
No. 
No. 


60 

6 

10 


Gutta-percha bed-covers .... 


No.' 


' 8 


FURNITURE, ETC. 










Basins, tin (small) ..... 


■• 


2 






" wash, hand . , 


" 


3 


No. 


8 


Bed pans, metal . 


" 


1 


No. 


S 


Buckets, leather ..... 


" 


2 


No. 


4 


Corks, assorted ..... 


Doz. 


8 


No. 


12 


Corkscrew ...... 


No. 




Doz. 


8 


Funnel, £-pint (glass) .... 


No. 




No. 


4 


Grater, nutmeg ..... 


No. 








Hatchet ...... 


No. 








Hone ....... 


No. 








Lanterns, glass ..... 


No. 








Measure, graduated, 2-oz .... 


No. 








" " minim 


No. 








Medicine measuring glasses .... 


No. 








Mill, coffee ..... 


No. 








Mortar and pestle ..... 


No. 








Pill boxes ...... 


Papers 








Pill tiles ...... 


No. 








Razor and strop (in case) .... 


No. 








Scales and weights, prescription 


No. 








" shop .... 


No. 








Sheepskins, dressed ..... 


No. 








Spoons, table ..... 










Spatulas, 3 and 6 in 


No." 


2 


No. 


72 


Tumblers, tin ..... 










Urinals, glass ...... 


No.' 


2 


No. 


6 


Vials, assorted .... 


Doz, 


2 


No. 


4 



36 



MEMOIR OF LETTERMAN. 



The following articles, in addition to those given in the foregoing table, will be 
carried in the box of each Ambulance, under the driver's seat, and will be kept there 
at all times, excepting the hard bread, which will only be placed in the box when there 
is a probability of an engagement. These boxes will be locked, and the keys kept by 
the Surgeon-in-Chief of Brigade, who will, by weekly inspections, ascertain that each 
Ambulance has the articles required, and that they are used for no other purpose than 
that for which they are intended, viz.: in the Field Hospitals, upon the field of battle, 
except in cases of emergency, and then only upon the order of the Medical Director of 
the Corps. 



ARTICLES. 


In each 
Ambulance. 


Bedsacks ........ 

Beef stock, 2-lb. cans ...... 

Buckets, leather ....... 

Hard bread ....... 

Kettles, camp (assorted sizes) ..... 

Lantern and candle ...... 

Plates, tin ....... 

Spoons, table ....... 

Tumblers, tin ....... 


No. 3 

6 

" I 

Lbs. io 

No. 3 

" i 

6 

6 

6 



Jona. Letterman, 
Surgeon U. S. Army, Medical Director. 



III. 



Field Hospitals. 



HEAD-QUARTERS ARMY OF THE POTOMAC, 

Medical Director's Office, 
October 30, 



1862. 



[circular.] 

Sir : In order that the wounded may receive the most prompt and efficient atten- 
tion during and after an engagement, and that the necessary operations may be 
performed by the most skilful and responsible Surgeons at the earliest moment, the 
following instructions are issued for the guidance of the Medical Staff of this Army, 
and Medical Directors of Corps will see that they are promptly carried into effect : 

Previous to an engagement, there will be established in each Corps a hospital 
for each Division, the position of which will be selected by the Medical Director of 
the Corps. 

The organization of the hospital will be as follows : 

1st. A Surgeon, in charge ; one Assistant Surgeon, to provide food and shelter, 
etc. ; one Assistant Surgeon, to keep the records. 

2d. Three Medical Officers, to perform operations ; three Medical Officers, as 
assistants to each of these officers. 

3d. Additional Medical Officers, Hospital Stewards, and Nurses of the Division. 

The Surgeon in charge will have general superintendence, and be responsible 
to the Surgeon-in-chief of the Division for the proper administration of the hospital. 
The Surgeon-in-chief of Division will detail one Assistant Surgeon who will report to, 



MEMOIR OF LETTERMAN. 37 

and be under the immediate orders of, the Surgeon in charge, whose duties shall be to 
pitch the hospital tents and provide straw, fuel, water, blankets, etc. ; and when 
houses are used, put them in proper order for the reception of wounded. This 
Assistant Surgeon will, when the foregoing shall have been accomplished, at once 
organize a kitchen, using for this purpose the hospital mess chests and the kettles, 
tins, etc., in the ambulances. The supplies of beef stock and bread in the ambu- 
lances, and of arrow-root, tea, etc., in the hospital wagon, will enable him to prepare 
quickly a sufficient quantity of palatable and nourishing food. All the cooks, and 
such of the Hospital Stewards and Nurses as may be necessary, will be placed under 
his orders for these purposes. 

He will detail another Assistant Surgeon, whose duty it shall be to keep a com- 
plete record of every case brought to the hospital, giving the name, rank, company, 
and regiment ; the seat and character of injury ; the treatment ; the operation, if any 
be performed ; and the result ; which will be transmitted to the Medical Director of 
the Corps, and by him sent to this office. 

This officer will also see to the proper interment of those who die, and that the 
grave is marked with a head-board, with the name, rank, company, and regiment 
legibly inscribed upon it. 

He will make out two " Tabular statements of wounded," which the Surgeon-in- 
chief of Division will transmit within thirty-six hours after a battle, one to this office 
(by a special messenger, if necessary) and the other to the Medical Director of the 
Corps to which the hospital belongs. 

There will be selected from the Division, by the Surgeon-in-chief, under the 
direction of the Medical Director of the Corps, three Medical Officers, who will be 
the operating staff of the hospital, upon whom will rest the immediate responsibility 
of the performance of all important operations. In all doubtful cases, they will con- 
sult together, and a majority of them shall decide upon the expediency and character 
of the operation. These officers will be selected from the Division without regard to 
rank, but solely on account of their known prudence, judgment, and skill. The 
Surgeon-in-chief of the Division is enjoined to be especially careful in the selection of 
these officers, choosing only those who have distinguished themselves for surgical 
skill, sound judgment, and conscientious regard for the highest interests of the 
wounded. 

There will be detailed three Medical Officers to act as assistants to each one of 
these officers, who will report to him and act entirely under his direction. It is sug- 
gested that one of these assistants be selected to administer the anaesthetic. Each 
operating surgeon will be provided with an excellent table from the hospital wagon, 
and, with the present organization for field hospitals, it is hoped that the confusion 
and the delay in performing the necessary operations so often existing after a battle 
will be avoided, and all operations hereafter ho. primary. 

The remaining Medical Officers of the Division, except one to each Regiment, 
will be ordered to the hospitals to act as dressers and assistants generally. Those 
who follow the Regiments to the field will establish themselves, each one at a tempo- 
rary depot, at such a distance or situation in the rear of his Regiment as will insure 
safety to the wounded, where they will give such aid as is immediately required ; and 
they are here reminded that, whilst no personal consideration should interfere with 
their duty to the wounded, the grave responsibilities resting upon them render any 
unnecessary exposure improper. 

The Surgeon-in-chief of the Division will exercise general supervision, under the 
Medical Director of the Corps, over the medical affairs in his division. He will see 
that the officers are faithful in the performance of their duties in the hospital and upon 



38 MEMOIR OF LETTERMAN. 

the field, and that, by the ambulance corps, which has heretofore been so efficient, the 
wounded are removed from the field carefully and with despatch. 

Whenever his duties permit, he will give his professional services at the hospital — 
will order to the hospital as soon as located all the hospital wagons of the brigades, the 
hospital tents and furniture, and all the hospital stewards and nurses. He will notify 
the Captain commanding the ambulance corps, or, if this be impracticable, the First 
Lieutenant commanding the Division ambulances, of the location of the hospital. 

No Medical Officer will leave the position to which he shall have been assigned 
without permission, and any officer so doing will be reported to the Medical Director 
of the Corps, who will report the facts to this office. 

The Medical Directors of Corps will apply to their Commanders on the eve of a 
battle for the necessary guard and men for fatigue duty. This guard will be particu- 
larly careful that no stragglers be allowed about the hospital, using the food and 
comforts prepared for the wounded. 

No wounded will be sent away from any of these hospitals without authority from 
this office. 

Previous to an engagement, a detail will be made by Medical Directors of Corps of 
a proper number of Medical Officers, who will, should a retreat be found necessary, 
remain and take care of the wounded. This detail Medical Directors will request the 
Corps Commanders to announce in orders. 

The skilful attention shown by the Medical Officers of this Army to the wounded 
upon the battle-fields of South Mountain, Crampton's Gap, and the Antietam, under 
trying circumstances, gives the assurance that, with this organization, the Medical Staff 
of the Army of the Potomac can with confidence be relied upon under all emergencies, 
to take charge of the wounded entrusted to its care. 

Very respectfully, your obedient servant, Jona. Letterman, 

Medical Director. 



IV. 

HEAD-QUARTERS, ARMY OF THE POTOMAC, 

Camp, near Culpepper Court-House, Va., 

September 30, 1863. 

Circular, ) 
Ambulances, etc. J 

I. Ambulances are issued by the Quartermaster's Department for the sole pur- 
pose of transporting sick and wounded, upon requisitions approved by the Medical 
Director and Corps Commander. 

II. Officers of the Ambulance Corps will receipt for ambulances, wagons, harness, 
horses, mules, hospital, and other tents, and all other articles of Quartermaster's prop- 
erty which may come under their charge. They will be held accountable, and will 
make their returns for the same as required by existing regulations. 

III. For all purposes connected with the transportation of sick or wounded, or 
medical supplies, these officers are subject to the direct control of the Medical Depart- 
ment ; but in drawing forage, horses, accountability of property, they are subject to 
the orders of the Chief Quartermasters of Corps, the same as other officers doing duty 
in the Quartermaster's Department. 

[Signed] Rufus Ingalls, 

Brigr.-General, Chief Quartermaster. 
I concur in the above. 

[Signed] Jonathan Letterman, 

Medical Director, A. P. 



LBJa'12 



